Advancing Oncology through Imaging: Evaluating FDG-PET's Role in Cancer Diagnosis and Staging
Abstract
Purpose: Fluorine-18 fluorodeoxyglucose positron emission tomography (18F-FDG PET) represents a valuable functional molecular imaging technique. Through non-invasive means, 18F-FDG PET allows for the assessment of glucose metabolic activity in living biological systems. Its utility in oncology is well established, with applications in tumor diagnosis, staging, and treatment monitoring.
The purpose of this study is to conduct a systematic review assessing the indicative value and effect on the clinical management of 18F-FDG PET/CT for various cancer types based on the current literature.
Materials and Methods: An inclusive search of the PubMed, Google Scholar, and Science Direct databases was performed to identify relevant studies published from 2022 to the present. Records were screened according to predefined inclusion and exclusion criteria. A full-text review of the eligible studies was independently conducted by two reviewers.
Results: Twenty-one primary research articles met the inclusion criteria and encompassed several cancer types. Evidence demonstrates superior detection, characterization, and staging compared with anatomical imaging alone. Advantages have been substantiated for head/neck, lung, and brain cancers, as well as lymphomas. The significant associations between 18F-FDG uptake and clinical features validated the molecular profiling capacity.
Conclusion: 18F-FDG PET provides crucial metabolic tumor information, augmenting conventional approaches. Specific diagnostic values have been established for diverse oncological applications. While technical refinements are ongoing, 18F-FDG PET plays an expanding role in multimodal cancer algorithms according to guidelines. Continued investigation aims to further optimize these techniques and clarify their comparative effectiveness.
2- Shivani Ahlawat, Jan Fritz, Carol D Morris, and Laura M Fayad, "Magnetic resonance imaging biomarkers in musculoskeletal soft tissue tumors: review of conventional features and focus on nonmorphologic imaging." Journal of Magnetic Resonance Imaging, Vol. 50 (No. 1), pp. 11-27, (2019).
3- Daryoush Shahbazi-Gahrouei, Pegah Moradi Khaniabadi, Bita Moradi Khaniabadi, and Saghar Shahbazi-Gahrouei, "Medical imaging modalities using nanoprobes for cancer diagnosis: A literature review on recent findings." Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, Vol. 24(2019).
4- Mohan Tian, Yingci Li, and Hong Chen, "18F-FDG PET/CT Image Deep Learning Predicts Colon Cancer Survival." Contrast Media & Molecular Imaging, Vol. 2023(2023).
5- Cici Zhang, Zhishan Liang, Wei Liu, Xuwen Zeng, and Yuzhen Mo, "Comparison of whole-body 18F-FDG PET/CT and PET/MRI for distant metastases in patients with malignant tumors: a meta-analysis." BMC cancer, Vol. 23 (No. 1), pp. 1-14, (2023).
6- Atsutaka Okizaki, Michihiro Nakayama, Kaori Nakajima, and Koji Takahashi, "A novel iterative modified bicubic interpolation method enables high-contrast and high-resolution image generation for F-18 FDG-PET." Medicine, Vol. 96 (No. 52), (2017).
7- Renata Milardovic, Nermina Beslic, Amera Sadija, Sejla Ceric, Melika Bukvic, and Lejla Dzananovic, "Role of 18F-FDG PET/CT in the Follow-up of Colorectal Cancer." Acta Informatica Medica, Vol. 28 (No. 2), p. 119, (2020).
8- Stephane Chauvie and Fabrizio Bergesio, "The strategies to homogenize PET/CT metrics: the case of onco-haematological clinical trials." Biomedicines, Vol. 4 (No. 4), p. 26, (2016).
9- Yu-Ping Xu and Min Yang, "Advancement in treatment and diagnosis of pancreatic cancer with radiopharmaceuticals." World journal of gastrointestinal oncology, Vol. 8 (No. 2), p. 165, (2016).
10- Indraja D Dev, Venkatesh Rangarajan, Nilendu C Purandare, and Ameya D Puranik, "Molecular imaging of Glial tumors: Established and emerging tracers." Indian Journal of Neurosurgery, (2023).
11- Salvatore Annunziata, Giorgio Treglia, Carmelo Caldarella, and Federica Galiandro, "The Role of 18 F-FDG-PET and PET/CT in Patients with Colorectal Liver Metastases Undergoing Selective Internal Radiation Therapy with Yttrium-90: A First Evidence-Based Review." The Scientific World Journal, Vol. 2014(2014).
12- Steven P. Rowe and Martin G. Pomper, "Molecular imaging in oncology: Current impact and future directions." CA: A Cancer Journal for Clinicians, Vol. 72 (No. 4), pp. 333-52, (2022).
13- Lanying Li, Xin Hu, Jiao Ma, Songsong Yang, Weidong Gong, and Chunyin Zhang, "A systematic review of [68Ga]Ga-DOTA-FAPI-04 and [18F]FDG PET/CT in the diagnostic value of malignant tumor bone metastasis." (in English), Frontiers in Oncology, Systematic Review Vol. 122022-November-10 (2022).
14- Marina Mikhail Fouad Hanna, Ahmed Mohamed Monib, Ahmed Mohamed Osman, and Ahmed ElShimy, "Comparative Study between 18F-FDG PET Scan and Conventional CT in Assessment of Non-Small Cell Lung Cancer Patients After Treatment." (2022).
15- Paolo Bossi et al., "Nasopharyngeal Carcinoma: ESMO-EURACAN Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up†." Annals of Oncology, (2021).
16- Bruce D. Cheson et al., "Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification." Journal of Clinical Oncology, (2014).
17- Martin Dreyling et al., "Newly Diagnosed and Relapsed Follicular Lymphoma: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up." Annals of Oncology, (2021).
18- Lennart Flygare, Seçil Telli Erdoğan, and Karin Söderkvist, "PET/MR Versus PET/CT for Locoregional Staging of Oropharyngeal Squamous Cell Cancer." Acta Radiologica, (2022).
19- S. Cebeci et al., "Diagnostic performance of FDG PET/MRI for cervical lymph node metastasis in patients with clinically N0 head and neck cancer." (in eng), Eur Rev Med Pharmacol Sci, Vol. 27 (No. 10), pp. 4528-35, May (2023).
20- Paulina Cegła et al., "Detection of a Second Primary Cancer in a 18f-Fluorocholine PET/CT – Multicentre Retrospective Analysis on a Group of 1345 Prostate Cancer Patients." Nuclear Medicine Review, (2022).
21- Shengbing Zang et al., "Thymic Extranodal Marginal-Zone Lymphoma of Mucosa-Associated Lymphoid Tissue: Pathological Features, 18f-FDG PET/CT Findings and Prognosis in 12 Cases." Frontiers in Medicine, (2022).
22- Cristina Ferrari et al., "Lesion-to-Liver SUVmax Ratio to Improve the Prognostic Value of the End of Treatment PET/CT in Diffuse Large B-Cell Lymphoma." Journal of Clinical Medicine, (2022).
23- Musa Ali Mufti, Robert Matthews, Ezemonye Madu, Kavitha Yaddanapudi, and Dinko Franceschi, "“Low Dose MR” Dixon Technique for Imaging FDG PET-MR Lymphoma." World Journal of Nuclear Medicine, (2022).
24- Tony Kiat Hon Lim et al., "KRAS G12C in advanced NSCLC: prevalence, co-mutations, and testing." Lung Cancer, Vol. 184p. 107293, (2023).
25- Giorgio Treglia, Domenico Albano, Francesco Dondi, Francesco Bertagna, and Olivier Gheysens, "A role of FDG PET/CT for Response Assessment in Large Vessel Disease?" Seminars in Nuclear Medicine, Vol. 53 (No. 1), pp. 78-85, 2023/01/01/ (2023).
26- Richard Black, Jelle Barentsz, David Howell, David G. Bostwick, and Stephen B. Strum, "Optimized 18F-FDG PET-CT Method to Improve Accuracy of Diagnosis of Metastatic Cancer." Diagnostics, Vol. 13 (No. 9), p. 1580, (2023).
27- Ki Seong Park et al., "Precise Characterization of a Solitary Pulmonary Nodule Using Tumor Shadow Disappearance Rate-Corrected F-18 FDG PET and Enhanced CT." Medicine, (2022).
28- Annan Zhang, Xiangxi Meng, Yan yao, Xin Zhou, Yan Zhang, and Nan Li, "Head‑to‑head Assessment of 68Ga-Dota-Fapi-04 PET/CT vs 18 F-FDG PET/CT in Fibroblastic Tumors." (2022).
29- K. L. Cole, M. C. Findlay, M. Kundu, C. Johansen, C. Rawanduzy, and B. Lucke-Wold, "The Role of Advanced Imaging in Neurosurgical Diagnosis." (in eng), J Mod Med Imag, Vol. 1(2023).
30- Andrey Postnov et al., "First-in-Man Noninvasive Initial Diagnostic Approach of Primary CNS Lymphoma Versus Glioblastoma Using PET With 18f-Fludarabine and L-[Methyl-11C]Methionine." Clinical Nuclear Medicine, (2022).
31- Maya Paran, Katerina Shulman, Boris Kessel, and Jasmin Dagan, "Synchronous Malignancies Identified by PET-CT Scan in Breast Cancer Patients." Rambam Maimonides Medical Journal, (2022).
32- Bawinile Hadebe, Lerwine Harry, Tasmeera Ebrahim, Venesen Pillay, and Mariza Vorster, "The role of PET/CT in breast cancer." Diagnostics, Vol. 13 (No. 4), p. 597, (2023).
33- Wei Guo et al., "Gallium-68-Labelled Fibroblast Activation Protein Inhibitor PET/CT in the Clinical Diagnosis and Management of Breast Cancer: Comparison With [18F]FDG PET/CT." (2022).
34- Ayat M. Kamal, O. Kamal, Hossam M. Sakr, and Susan A. Ali, "Role of 18f-FDG PET/CT in Evaluation of Recently Diagnosed Breast Cancer Patients." Egyptian Journal of Radiology and Nuclear Medicine, (2022).
35- Hongyu Hu et al., "The Diagnostic Performance of 18f-FDG PET/CT Versus 18f-NaF PET/CT in Breast Cancer With Bone Metastases: An Indirect Comparative Meta-Analysis." (2023).
36- Gary A. Ulaner, "Breast Cancer and Physiologic Avidity From Breast Feeding on FDG PET/CT." Clinical Nuclear Medicine, (2023).
37- Göksel Alçın et al., "68Ga-Fapi-04 PET/CT in Selected Breast Cancer Patients With Low FDG Affinity." Clinical Nuclear Medicine, (2023).
38- Alejandra d A. Gómez et al., "Correlation Between MAMMI-PET Findings and Anatomopathological Outcomes in Breast Cancer Patients." Nuclear Medicine Communications, (2022).
39- Sandhya Bodapati et al., "18f-Fes PET/CT Improves the Detection of Intraorbital Metastases in Estrogen-Receptor-Positive Breast Cancer: Two Representative Cases and Review of the Literature." Tomography, (2022).
40- Cici Zhang, Zhongxing Liang, Wei Liu, Xuwen Zeng, and Yuzhen Mo, "Comparison of Whole-Body 18f-FDG PET/CT and PET/MRI for Distant Metastases in Patients With Malignant Tumors: A Meta-Analysis." BMC Cancer, (2023).
41- Matteo Zanovello et al., "Brain stem glucose hypermetabolism in amyotrophic lateral sclerosis/frontotemporal dementia and shortened survival: an 18F-FDG PET/MRI study." Journal of Nuclear Medicine, Vol. 63 (No. 5), pp. 777-84, (2022).
42- Grace C Blitzer, Poonam Yadav, and Zachary S Morris, "The role of MRI-guided radiotherapy for soft tissue sarcomas." Journal of Clinical Medicine, Vol. 11 (No. 4), p. 1042, (2022).
43- Janna Morawitz et al., "Comparison of nodal staging between CT, MRI, and [18F]-FDG PET/MRI in patients with newly diagnosed breast cancer." European Journal of Nuclear Medicine and Molecular Imaging, Vol. 49 (No. 3), pp. 992-1001, 2022/02/01 (2022).
44- Nimish Seth et al., "18F-FDG PET and PET/CT as a diagnostic method for Ewing sarcoma: A systematic review and meta-analysis." Pediatric Blood & Cancer, Vol. 69 (No. 3), p. e29415, (2022).
45- Mark Quigg and Bijoy Kundu, "Dynamic FDG-PET demonstration of functional brain abnormalities." Annals of Clinical and Translational Neurology, Vol. 9 (No. 9), pp. 1487-97, (2022).
46- Styliani Mantziari et al., "18f- FDG PET/CT-derived Parameters Predict Clinical Stage and Prognosis of Esophageal Cancer." BMC Medical Imaging, (2020).
47- Joseph Reza et al., "Implementation of Staging Guidelines in Early Esophageal Cancer." Annals of Surgery, (2023).
48- Irène G. Sérézal, Salah Ferkal, Lionel Lerman, Sébastien Mulé, Benoît Funalot, and Pierre Wolkenstein, "[18F]FDG Positron Emission Tomography With Whole Body Magnetic Resonance Imaging ([18f]fdg-Pet/Mri) as a Diagnosis Tool in Schwannomatosis." Orphanet Journal of Rare Diseases, (2021).
49- Maha Omar Mohamed Elshalakani, Nivine Chalabi, H. M. Hanafy, and Azza I. Othman, "Diagnostic Value of FDG-PET/CT in Fever of Unknown Origin." Egyptian Journal of Radiology and Nuclear Medicine, (2022).
50- H. Ferjani et al., "Vertebral Sarcoidosis: Diagnosis to Management." Acta Orthopaedica Belgica, (2022).
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Issue | Vol 11 No 4 (2024) | |
Section | Literature (Narrative) Review(s) | |
DOI | https://doi.org/10.18502/fbt.v11i4.16515 | |
Keywords | ||
Fluorodeoxyglucose Positron Emission Tomography Positron Emission Tomography Diagnosis Cancer Oncology Staging |
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